The use of 0.2% chlorhexidine in the absence of a structured mechanical regimen of oral hygiene following the non-surgical treatment of periodontitis.
The aim of the present study was to evaluate a 0.2% chlorhexidine mouthrinse following the non-surgical treatment of advanced human periodontitis in the absence of a structured mechanical oral hygiene regimen. 10 patients and a total of 1483 sites were used. Recordings for plaque, bleeding, pocket depth and attachment levels were made at baseline and at 3, 6, 9, and 12 months. Debridement was performed under local anaesthesia. No instruction or reinforcement in mechanical oral hygiene procedures was given at any time. However, at each visit the patients were instructed in the 2x daily use of 0.2% chlorhexidine mouthwash. The plaque indices, scored as % of sites with removable deposits, showed negligible improvement from baseline scores of 80%-100% for all categories of initial probing depth. Mean bleeding score was reduced to 10-20% irrespective of initial probing pocket depth, site location or tooth surface location. Sites > or = 7 mm at baseline demonstrated a reduction in mean probing pocket depth of 3.9 mm and a gain in mean probing attachment level of 2.5 mm. Moderately deep sites (4-6.5 mm) demonstrated a reduction in mean probing pocket depth of 2 mm and a gain in mean probing attachment level of 0.8 mm. Shallow sites (< or = 3.5 mm) demonstrated a reduction in mean probing pocket depth of 0.5 mm and a loss in mean probing attachment level of 0.2 mm. Site-specific attachment level analysis demonstrated that over 80% of losing sites were shallow with low bleeding frequency, indicating that the loss of attachment may have occurred for reasons other than inflammatory periodontal disease. The results indicate that chlorhexidine can be used as an adjunct to inadequate mechanical oral hygiene over an observation period of 1 year.
Christie
P
P
School of Dental Science, Trinity College, Dublin, Ireland.
Claffey
N
N
Renvert
S
S
D000328:Adult; D000772:Anesthesia, Local; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003773:Dental Plaque / Q000188:drug therapy / Q000628:therapy; D003774:Dental Plaque Index; D012534:Dental Scaling; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000628:therapy; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use*; D009910:Oral Hygiene; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000628:therapy; D010514:Periodontal Pocket / Q000188:drug therapy / Q000628:therapy; D010518:Periodontitis / Q000188:drug therapy / Q000628:therapy*; D016745:Root Planing; D013357:Subgingival Curettage
D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; C010882:chlorhexidine gluconate; D002710:Chlorhexidine